Ischemic Colitis

Wittenberg, J; Athanasoulis, Christos A.; Williams, Lester F.; Paredes, Santiago; O’Sullivan, Philip; Brown, Borden

doi:10.2214/ajr.123.2.287

Cited by 51 publications

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“…Loss of thumbprinting has been reported during a single-contrast barium enema [9] when the colon 0364-2356/79/0004-0085 $01.00 9 1979 Springer-Verlag New York Inc. Other typical features, such as narrowing, spasm, and funnelling, are still present (Fig. 1 B).…”

Section: Discussionmentioning

confidence: 89%

Obliteration of thumbprinting with double-contrast enemas in acute ischemic colitis

Bartram

1979

Gastrointest Radiol

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Section: Discussionmentioning

confidence: 89%

Obliteration of thumbprinting with double-contrast enemas in acute ischemic colitis

Bartram

1979

Gastrointest Radiol

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“…In many studies, NOMI was not distinguished from ischemic colitis. Wittenberg et al reported that NOMI typically occurs in the area of the bowel perfused by the SMA, whereas ischemic colitis usually presents in the area perfused by the inferior mesenteric artery [ 12 ]. Usually, a long range of the bowel becomes discontinuously necrotic in a patient with NOMI.…”

Section: Discussionmentioning

confidence: 99%

“…Only a few cases of NOMI localized in the colon were reported [ 7 , 12 ], and the ascending colon was the most frequently reported site. There was no report of a case localized in the transverse colon.…”

Section: Discussionmentioning

confidence: 99%

Non-occlusive mesenteric ischemia localized in the transverse colon: a case report

et al. 2017

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BackgroundNon-occlusive mesenteric ischemia (NOMI) is ischemia of the mesentery that is caused by hypoperfusion or vasospasm without any thrombosis. NOMI is difficult to diagnose by physical examination alone. Although angiographic examination of the superior mesenteric artery (SMA) is the usual diagnostic method used, it is an invasive examination. Usually, a long range of the bowel becomes discontinuously necrotic in NOMI. Here, we report a rare case of NOMI localized in the transverse colon that was diagnosed by computed tomography (CT) angiography which is a minimally invasive examination.Case presentationA 72-year-old woman was referred to our hospital for further treatment of abdominal pain that developed 1 day before presentation. Contrast-enhanced abdominal CT scan revealed attenuated enhancement of the transverse colon. CT angiography showed SMA irregularities due to vasospasm. The middle colic artery could not be detected by CT angiography. No occlusion due to thrombus or embolism in the SMA and superior mesenteric vein was observed. Based on the findings, NOMI was suspected, and emergency laparotomy was performed, which revealed a segmentally necrotic transverse colon. The necrotic bowel was resected, and stomas were created.ConclusionThe presence of hypotension in the patient necessitated the use of CT angiography, which proved very useful in the early diagnosis of the present case. Thus, if intestinal ischemia is suspected, even in case of a short segment, CT angiography should be performed.

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“…Reprint requests: Yoshio Mishima, M.D., Department of Surgery, University of Tokyo Faculty of Medicine, 7-3-1, Hongo, Bunkyoku, Tokyo, 113 Japan. description of the disease by Boley et al [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. During the past 10 years, we have encountered 38 patients with bowel lesions thought to be caused by an ischemic process, including 18 cases of ischemic colitis and 20 cases of radiation enteropathy.…”

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Experimental studies of ischemic enterocolitis

Mishima

Horie

1980

World j. surg.

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Occlusion of the minute vessels of the bowel produces hemorrhage, ulceration, and necrosis of the bowel wall. To clarify the pathophysiology of the ischemic lesions caused by minute vessel occlusion, a microbarium suspension was injected into the mesenteric vessels of mongrel dogs. The pathological process in the bowel wall was parallel to the degree and extent of occlusion. The changes observed in these experimental studies were similar to those encountered in patients with ischemic enterocolitis. From our clinical and experimental analyses, the bowel lesions caused by minute vessel occlusion were classified into 3 categories according to the layer of the bowel wall involved, namely (a) mucosal, (b) submucosal and muscular, and (c) all layers of the bowel wall. In the lesions confined to the mucosal layer, the pathological processes were transient and reversible, and special treatment was not necessary since spontaneous recovery could be expected in almost all cases without any functional disturbance. When the ischemic changes involved the submucosal layer beyond the base of the crypts, ulceration almost always developed and was followed by a high incidence of stenosis due to scar formation. In this type of lesion, surgical treatment is required if stenosis persists after healing of the intestinal isehemic lesions. When the ischemic processes extended through all layers of the bowel wall, characteristic endoscopic findings were observed even in the early stages. Because of the high mortality rate, immediate surgical intervention is mandatory.

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Ischemic Colitis

Cited by 51 publications

References 0 publications

Obliteration of thumbprinting with double-contrast enemas in acute ischemic colitis

Obliteration of thumbprinting with double-contrast enemas in acute ischemic colitis

Non-occlusive mesenteric ischemia localized in the transverse colon: a case report

Experimental studies of ischemic enterocolitis

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